BEING ALIVE; May 1995
Thomas P. McCormack

Better yet, if your SSDI and any other income total less than $642.50 per month, the government will also pay the $716 hospital admission deductible, the $100 doctor bill deductible and the 20% doctor bill copayment that Medicare doesn't cover.

The new benefits for disabled Medicare patients are part of the Qualified Medicare Beneficiary (QMB) and Special Limited Medicare Beneficiary (SLMB) programs run by local welfare offices (not Social Security offices) through state Medicaid programs, even though they serve Social Security recipients on Medicare. To be eligible, you may not have assets other than a vehicle or home of any value and more than $4,000 in the bank.

In counting your SSDI, be sure to figure the total you get before the $46.10 Medicare deduction: it's the total SSDI benefit that counts-not the net you actually get in your check. When you apply at the welfare office, bring your birth certificate, Medicare card, driver's license or other picture ID, the latest letter you got from Social Security telling you what your benefit is (call 800.772.1213 for a new one if you've lost this form), papers showing any other income, any deed, mortgage or lease papers, auto registration and bank statements.

Applying for SLMB and QMB at the welfare office now can bring a quick $46.10 increase in your SSDI check-and coverage of hospital and doctor bills you'd have to pay yourself. It may not be worth waiting two years for, true, but it's sure not chump change either.

Medicare, QMB and SLMB won't help you with prescription drugs or care not covered at all in the Medicare benefit package. But if you're applying for QMB or SLMB at a welfare office in California, Maine, Rhode Island, Connecticut, New York, New Jersey or Florida, ask for Medicaid while you're at it. Medicaid (called MediCal in California) covers drugs and other items not covered by Medicare, QMB or SLMB and in those states the Medicaid income level is as high as-or almost as high as-the QMB and SLMB levels. If you can't qualify for Medicaid, though, don't forget the AIDS Drug Assistance Program (ADAP); call 800.342.AIDS to find out how to apply in your state. If ADAP doesn't cover all the drugs you need and you can't get Medicaid either-but you live in Connecticut, Illinois, Maine, Maryland or New Jersey-you can apply for your state's general drug assistance program. Call the city or county aging office (even if you're not elderly) for details.

If all else fails and you aren't eligible for ADAP-or ADAP doesn't cover drugs you can't afford to buy yourself--call the Pharmaceutical Manufacturers' Association (202.835.3400) and the Senate Aging Committee (202.224-5364) for their lists of free drug programs, and then have your doctor order you free prescriptions from those lists.

(Thomas P. McCormack handled Medicare and Medicaid with the federal Health Care Financing Administration, authored the AIDS Benefits Handbook, and served as Public Benefits Policy Specialist for the National Association of People with AIDS.)

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